The answer is basically yes. Private insurance companies are now mandated by the Affordable Care Act also known as “Obama Care” to offer some type of substance abuse treatment coverage to their members. The ACA also considers substance abuse as an important health care benefit for US citizens. This means that most insurance providers can’t completely withhold substance use disorder coverage. You exact coverage, although will be dependent on the state you bought benefits in and the exact health care plan you chose such as HMO or PPO plan.
Insurance firms may need their members to choose from a small set of approved or “in-network” providers, making sure that treatment comes at a lower cost
The Affordable Care Act & Drug Rehab
Currently, concerns about insurance coverage (or lack thereof) act as a barrier to individuals suffering from addiction receiving the treatment they require, despite increasing coverage. As a matter of fact, only one out of ten people suffering from substance abuse receives the correct treatment they require. Unfortunately, money problems and lack of insurance are among the reasons for this disparity.
Mental health and addiction treatment have become less stigmatized in recent years, in some ways due to the ACA. Still, some insurance firms may still make it hard for people suffering from addiction to get the help they require.
In the past, a number of insurance providers didn’t cover substance abuse treatment of any kind. Insurance companies also used to be able to withhold coverage for addiction treatment, either entirely or partially, to members but based on whether their problem that is substance use disorder or mental health condition was seen as “pre-existing conditions”.
When the former President Obama signed the Affordable Care Act in 2010, it encouraged the wave of change that was already happening in some insurance companies. The ACA mandates that all plans it encompasses offer coverage for behavioral and mental health services, as well as substance abuse treatment.
How much an insurance firm covers rehab programs still depends on each person’s individual plan and the treatment program they go for. In some cases, an individual seeking treatment must get a referral from their primary care doctor before their insurance provider pays for treatment.
In addition, the Affordable Care Act also mandated that such policies cover the treatment of mental disorders. The majority of the people who suffer from substance abuse addiction also struggle with co-occurring mental health disorders, like depression and anxiety. Treatment medications, therapies offered and even the time a patient spends at an inpatient facility are often covered.